Seminar - May 15 & 16 , 2014



      You’re Invited

                    Claims Scrubber Seminar

                     Claims Adjudication

 

Tired of costly errors? Develop your claims scrubber

 

Most vital cost containment tool for Payers, TPAs, IPAs, MSOs, & Case Managers

 

                         Register Early – Limited to 14 Attendees

                                  Ask for additional seminar dates

 

 

Date:           May 15 & 16, 2014

Time:                    9:00 am to 5:00 pm

Place:                    5201 Blue Lagoon Drive, Suite 800

                   Miami, Florida 33126

Contact:     Phone:  305-227-2383  ask for Felicia or Paul

                   Fax:      786-364-7356

Email:         sales@accuchecker.com

 

 

Seminar Cost:  $875.00

Additional Participants: $600.00

                                                                      Credit Card & Company Checks Accepted

 

Fax or Email Registration Form:

Register today for the May 15 & 16, 2014 Seminar for Claims Scrubber Seminar.

Space is Limited. Register Early.

 

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Seminar on April 24 and 25 , 2014 - Miami, Florida

 

 

 

 

 

SEMINARS & CONSULTING SERVICES

CLAIMS ADJUDICATION

Tired of costly errors? Develop your claims scrubber

April 24 and 25 , 2014

Miami, Florida

 

A claims scrubber module represents the most basic cost containment tool for payers and TPAs in adjudicating claims and for IPA and MSO analyzing claims paid by the HMOs if risk agreements contracts are in place. Millions of dollars can be saved! 

A claims scrubber with pricing (fees) capabilities can simplify the job of case managers estimating claims of services rendered by providers that are not participating in the insurance company panel and are considered “out-of-network” 

 

Our HPP AccuChecker team has developed seven (7) claims scrubbers systems in the last fifteen years – we learned that a team of programmers and healthcare reimbursement experts working together can develop their own claims scrubber in 60 to 90 days. It is understood that adequate training and a good map of the adjudication rules will guarantee the success of the in-house scrubber.

 

A good in-house claims scrubber must:

 

·         Adhere to CMS and AMA adjudication guidelines in paying claims

·         Verify members participation in the insurance plan

·         Validate dates, places of service, procedures, modifiers, units, pricing, diagnosis (ICD-9-CM and ICD-10-CM) codes and co-payments

·         Adjust duplicate lines in claims

·         Keep an eye on UPCODING and the relationship between E & M procedures and places of service

·         Reject double billing when global fees and modifier 26 are charged simultaneously for the same day of service – common in hospital radiology services

·         Check medical necessity by matching procedures and diagnoses

·         Identify and react to UNBUNDLING by using up-to-date CCI tables

·         Track payment of bilateral and multiple procedures including endoscopy services

·         Follow basic rules on claims using numeric and alphanumeric modifiers for surgical, medical, diagnostic and rehabilitative services

·         On inpatient admissions observe that there is only one admitting physician and that double charges for ER and admission are flagged

·         In the case of Medicare and Medicaid HMOs stay in constant watch on the two major areas of waste and mismanagement by some of the Plans – Pharmacy and Behavioral Services

·         A more advance analyzer will take care of HEDIS and PQRS measures – Alerting by patients in file the measures required by member during the year and the status of measures pending for each participant during the pertinent filing period. 

FOR MORE INFORMATION ABOUT

CLAIMS ADJUDICATIONS

SEMINARS & CONSULTING SERVICES

Please contact us at (305) 227-2383

Email: sales@accuchecker.com

 

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